Doctors Nova Scotia president weighs in on recruiting family physicians

Dr. Leisha Hawker is nearly six months into her tenure as president of Doctors Nova Scotia. So far, she says her position has been both rewarding but “uniquely challenging.”

“It’s an interesting year, because we’re heading into negotiations in the near future,” she told CTV News in an interview on Tuesday. “So lots of chats with physicians across the province right now.”

She says those conversations have been focused on the need for family doctors.

“It’s interesting, because in the past with negotiations, when you talk to different physicians they often speak about their own experiences,” she said. “But, so far, talking to physicians across the province, whether or not they’re family doctors or specialists, they’re all saying, ‘We need to fix primary care. The funding needs to be focused on improving the primary care system.’”

The British Columbia government recently announced a new payment model with the hope of attracting and retaining physicians in that province.

The model will see full-time family doctors receiving about $385,000 per year, up from $250,000.

Dr. Hawker calls it a “really significant investment.”

“It’s unique in that’s valuing all the work that physicians do and not just kind of a fee-for-service model, so it recognizes the complexity of care that primary care has transitioned to over the years.”

B.C. doctors have criticized the "fee-for-service" payment model as being outdated. Dr. Hawker says the new model will now allow them to use their clinical judgement to determine how best to book their patients.

“And which of their patients need more time to really be able to focus on both complexity of care, but also preventative medicine.”

B.C. doctors also face high overhead costs and administrative work at their practices. Dr. Hawker says the issue is also affecting many office-based family doctors and specialists in Nova Scotia.

“It’s also important to note that a lot of newer, younger graduates of family medicine aren’t keen to be business owners,” she says. “They’re really looking for a model that’s like a team-based, collaborative approach, where they can just kind of clock in and they don’t have to worry about calling somebody to fix the fax machine. They want to focus on the patients.”

Dr. Hawker says, while competitive compensation is important to recruit family doctors, work environment is also something that comes into play.

“A lot of medical students and residents haven’t really seen family medicine as being a sustainable option in the past few years. They’re seeing the struggle that office-based family medicine doctors face. And with investments like this, it makes it more of a viable solution so we won’t be losing family medicine graduates to other fields of medicine like hospitals or emergency department work for instance.”

Adding to the family doctor shortage is the fact that there are not enough graduates to meet the need, she says.

“We have about 40 family medicine graduates per year and our target for recruitment is about 100 physicians per year for the next decade,” she says. “But we also have to look at the current shortage of physicians – it makes it hard to train because as you have more physicians moving into academic and teacher roles we’re taking away hours from clinical care as well. So it’s a bit of a chicken and an egg scenario.”

To help with the growing waitlist, people in Nova Scotia without a family doctor can access free, online medical appointments through Virtual Care Nova Scotia.

Dr. Hawker says virtual care is “here to stay” in the province.

“I know a lot of physicians, and patients too, have found it a really quite convenient way to work. A lot of my patients, instead of having to drive in from like Elmsdale to Halifax for instance, or other patients having to take taxis or multiple buses to get to my clinic and missing a lot of time from work. It’s been quite efficient for both the physician and a lot of my patients.”

According to Nova Scotia Health’s October report, there are now more than 116,00 people on the province’s waitlist for a family doctor.